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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />Rezoning $100 <br />— Special Use Permit — Division of Platted Lot $50 <br />Vacation of Right -of -Way $100 — Relocation of Dwelling $50 <br />PVariance to Zoning Ordinance $50 <br />Preliminary and Final Plat <br />$100 -4/ Minor Variance <br />Please complete form b t $25 <br />are insufficient, use additionalrsheetslnkeying in lnin k. If the spaces <br />item numbers: g formation to the Proper <br />proper <br />1.��f El i� R K k 3 <br />Name of Owner: (First) 6 17517 <br />(Middle) (Last) (Phone) <br />2. 33 c.� sr caunfi Road ko5Cw,Uc <br />Address of Owner: �/U S5113 <br />(No. and Street) (City) (State) <br />3. //0AIA H _ (Zip) <br />Name of Applicant <br />MO L 4 K fit) <br />: (First) (Middle) <br />(Last) (Phone) <br />4. o2 3 3 (e West <br />Address of Applicant: (No. and Street) �� <br />(City) (State) <br />5. 3 r c.��sf C0 ���1 l�.m <br />Street Address of Property Involved: �sev`((e �1I3 <br />6. Complete Legal Description of Property Involved: <br />ti <br />7. Date Property Acquired: <br />8. Present Use of Property: {►►�ee�wl Proposed Use of Property: <br />�eme <br />9. Present Zoning of Property: <br />Proposed Zoning of Property: _ <br />10. What plan or change makes this request necessarY• i s AsA- `� ��� e is q <br />� ern ` r e <br />11. What is the expected effect of the <br />Property values, health, safety, proposed change? (For example, on <br />Y, parking, traffic conditions, etc.) <br />